I’d like to point out that it’s illegal for a physician to refer to his spouse if the patient is on Medicare or Medicaid. It’s called the Stark Law.
Additionally, if my physician referred me to his spouse, I would find another physician. I find it really bordering on unethical even if you are on private insurance.
[quote=“deb922, post:61, topic:2106694”]
I’d like to point out that it’s illegal for a physician to refer to his spouse if the patient is on Medicare or Medicaid. It’s called the Stark Law.
Additionally, if my physician referred me to his spouse, I would find another physician. I find it really bordering on unethical even if you are on private insurance. [/quo
Yes and no on this. We use a neurologist that her husband is a very well known back/neck surgeon. She does use this group at Rush in Chicago but let’s everyone know who her husband is if they need his help. I really don’t have an issue with this at all. IN this group like every doctor has a subspecialty and he is one of the better one’s if this makes sense. They are always free to pick someone else or go somewhere else and they give a sheet with other doctors name but points out who her husband is. Again, I don’t see anything wrong with this. It’s different then say you HAVE to go to this person.
@Knowsstuff i was referring to @blossom who said she was happy with her gastro but the office referred her to the physician’s wife.
I was pointing out that the Stark Law prohibits that. If you are on Medicare or Medicaid.
If you are happy with the referral and it was disclosed, then that is a different situation.
Deb, thanks for the information. Not on Medicare or Medicaid, but it’s good to know for the future (once I hit the magic age…)
Sorry…going on little sleep since up to late looking at returns…LOL…sorry…
Same! It’s been a long day
My gyn tried selling supplements for a short period of time, but I think even he was a little uncomfortable with it.
My dentist recommends electric toothbrushes, and occasionally has coupons for them, but there is no hard sell at all.
My PCP did recommend her daughter when I said my husband needed a new PCP, but she’s the new doc in the practice with her mom so that seemed fine.
@bossom I like your phrasing when asking the new RA Tice about their “policy”. I wil be using that one! Thanks.
The saga continues. I have been searching for the new floss that was strongly recommended to me and have failed to find it at 2 grocery chains and a big box retailer. I’ve used all of the sample that was given to me and all I have in the house now is the brand that was previously recommended but is just not good enough now. Of course, I’ve been invited to buy the new floss directly from the dentist. I will keep searching for the new in stores I go to regularly and using up what I already have. I am simply not willing to make a special trip during a pandemic and not everything is available on Amazon!
I had cataract surgery and the surgeon did a bit of a push for accommodating lenses. Because I am on Medicare, if I chose to use conventional lenses, he would make very little but I think they were charging $3200 per accommodating lens, which I am sure provides for considerable profit. I read some papers and called some physicians and concluded that the accommodating lenses probably were a good idea, but I was a bit taken aback by the relatively aggressive recommendation for the lenses. Incidentally, they are in and are working very well.
So the question is when does a patient perceive competent medical advice as an oversell?
I can’t tell you how many people I suggest x to that would not only save time /money in the long run but reduce their pain now. Many had gone to “several second /, third opinions only to come back to get x and once did all said the same thing.” I really wished I did this sooner "… But they spent 2 to 3 x as much to disprove or find a cheaper solution… Lol…
Sometimes the medical suggestion is because the doctor has years of experience and can determine which product or X will be the most appropriate for you. Just because it is more expensive doesn’t mean it’s an upsell.
Just using your experience as an example…
I dropped my internist bc he was testing me for every dang thing. He had a lab in-office and tbh, it felt like he was defrauding the insurance companies. At the very least, it was borderline.
I switched dermatologists because every time I’d go in for a mole check, I’d leave with the impression that I was an old hag in need of botox, fillers, the works. Terrible for my ego. I like my derm now who offers all that stuff but doesn’t push it.
For cataract surgery, laser incisions were $1500 extra per eye. It was explained to me that laser incisions are more precise and less traumatic (gentler) to the eye than that from a hand held scalpel. Given my previous retinal detachment and repair (condition of that eye is a bit fragile) I saw that as less of an upsell and more of a better alternative.
Since most patients are not initially well informed about medical care options, it may come down to the patient’s existing level of suspicion of overselling (in any situation, not just health care), the provider’s way of speaking (e.g. a hard sell for the expensive option, versus laying out all of the options and telling the patient to take their time choosing), whether there is a surprise factor in the diagnosis or cost, and what the patient can afford to pay.
@Knowsstuff, good question. I think with a doctor or other provider with whom I had a good, trusting relationship, I might not seek additional information. In this case, I searched for the research on the efficacy of various approaches. I asked my concierge PCP and a good friend who is a very knowledgeable behavioral optometrist and an ophthalmologist that I knew. If our PCP had recommended something, I would not think she was doing it for profit even if it made her money, because I have a good sense of how she is wired.
The recommendation by the ophthalmologist was in a) my first meeting with him (so no trust built up); and b) after a very long morning of going into a room for a 3 minute test, waiting an hour, going into another room for a 5 minute test, waiting for another hour, etc. before seeing him 4 hours after my appointment started (so no reason to believe that he cares about his patients particularly if he organizes the practice that way).
I research almost everything. Credit probably goes to a dentist “friend” within a church we used to attend not long after we were married and had moved to a new area. Seemed “right” to go there (church/relationship, etc). The guy recommended a couple of thousand dollars worth of work each for both H and I, several cavities, sealing, multiple cleanings and more. We simply couldn’t afford it. I confided in my mom and she offered to help us out at her dentist when we went there on a visit.
Her dentist found just one cavity for me - none for H. Teeth were in good condition otherwise. We were stunned.
Returning to FL I found a different dentist and went there for a third opinion. No additional cavities for me. H had none.
Telling the story to both dentists, they told us to turn the first one in, but we just couldn’t. We did stop seeing him at church and kept mum about him in general. It was sad when other friends of ours told us they loved going to him - “it was super expensive at first because we needed a lot done, but it was ‘worth it’ and we’ve since paid off the debt.”
The dentist had a nice sized house and boat, etc. We know how he paid for it, at least partially off the backs of those without nearly as much money as he had.
To this day I wish we had had the guts to at least file with the state about our experience. If both other dentists were willing to back us up, something was really off.
At this point medically I let my “soon to be finished with med school lad” have a say in everything we consider. If he doesn’t know, he willingly researches for me using his more in depth resources.
So we have every patient sign a financial agreement on any large expense like over $500. Nothing is a surprise even though some patients say they didn’t know the costs when getting a bill but then we show them what they signed. This always amazes me. Trust me, I am learning from your stories and taking it in. I think we have to explain more and be upfront. My office really tries to be but can’t make everyone happy. We have a surgical operating room so like everything is written down with a cost value when the patient signs the forms.
So the doctor above has a large car, boat, etc. So… Yes, this is how he makes his money… Great… I used to have a side audio video business also. My patients never knew about it… I made a profit from that… That is a good thing not bad. Lots of my patients drive nicer cars and live in a bigger house then mine… So…
I have had 2 kids in college. I talk to tons of my patients my age with kids in college. We all complain about college costs etc etc. The nice part is I have helped several kids get into college that were my patient that had no guidance. I had them set up time with me with their parents, of course for free, and I helped guide them. These were patients that would never be able to afford this advice. One Mother came to me with her son when he got into Iowa State University on a scholarship. He said with tears in his eyes that his own father didn’t have faith in him and I was the only one that gave him the confidence…
Bet your doctors aren’t doing that… Lol ?
Sorry, just felt like sharing…
Creekland points out an interesting conundrum- using providers with whom you have a social or quasi social relationship.
I know my friends think I’m nuts, but I don’t want a lawyer, accountant, gynecologist, etc. who I see regularly at book club, dinners, etc. Even if I trust them implicitly, even if their ethics are above reproach-- I’ve heard doctors make comments about patients which should have gotten them reported. (An doctor-acquaintance of mine who saw me leaving the local hospital, asked in a friendly way “were you visiting someone?” and when I said yes- told him the patients name he grimaced and said “Terminal diagnoses are never easy”. The person I was visiting had not told anyone outside of the immediate family that the diagnosis was terminal. I felt this was a terrible violation).
So to me it’s a lot easier if I don’t have social relationships with dentist, doctors, etc. It’s hard to “fire” a friend!
I vividly remember a new dental hygenist selling me on the idea of redoing my crowns due to their age. She then went on and on about how she has never seen crowns as well done as mine and asked me all kinds of questions about the process (none of which I had answers to). Then she tried to close the sale and schedule a new crown and I was just left thinking - if my crowns are better than anything you’ve seen working here, why would I let you “fix” them?
My husband tried the same office and came away with a $7000 estimate for recommended repairs - including braces. We laughed and switched dentists.
@BunsenBurner I had the same offer for oral cancer screening! I asked what my risk factors are that makes it necessary and apparently it’s just having a mouth.